Metabolic Bone Disease In The Patient On Long-Term Parenteral Nutrition

Metabolic bone disease is a common problem for patients who require long-term parenteral nutrition. Osteoporosis and osteomalacia, the two major forms of metabolic bone disease, may lead to bone pain, fragility fractures, limited mobility and a decrease in the quality of life. When metabolic bone disease was first recognized in long-term parenteral nutrition patients it appeared to be due to solutions contaminated with high concentrations of aluminum. Parenteral nutrition no longer contains these large amounts of aluminum; however, these patients are still at risk for the development, or worsening of, existing metabolic bone disease. The parenteral nutrition formula should allow for optimal bone health with ongoing monitoring for the presence of metabolic bone disease to identify those who require additional medication to stabilize or improve their bone health. This review will discuss many of the aspects of metabolic bone disease in patients on long-term parenteral nutrition.